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General NPI Number Information
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NPI Number | 1134078744
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Entity Type | Organization
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Legal Business Name | RADICAL ELEVATION TEXAS
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 16510 NORTHCHASE DR STE 113
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City | HOUSTON
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State | TX
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Zip | 77060-3302
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Country | US
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Telephone | 702-608-1488
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Fax |
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Provider Business Mailing Address
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Address Line | 3551 E BONANZA RD STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89110-2198
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RADICAL ELEVATION
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Credential |
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Telephone | 702-482-7441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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